This invention relates to a medical simulator for modeling neuromuscular stimulation during surgery that is especially useful for training personnel in the medical and related arts or for demonstration or testing of medical apparatus used in conjunction with neuromuscular stimulation. More particularly, the invention relates to a method and associated apparatus for simulating neuromuscular stimulation in real time, such as ulnar nerve stimulation to detect the degree of neuromuscular blockade and the external stimulation of nerves to produce evoked potentials so as to monitor the integrity of nerves during surgery. Such simulation allows for the active participation of trainees with the simulation apparatus to experience real world medical procedures in a setting that closely mimics the real world.
The concepts involved in simulation of complex procedures are well established in the aviation and military arts. Simulation in the medical context is not so well developed. Various computer-controlled anesthesiological training simulators, such as those described in U.S. Pat. No. 3,520,071; D. M. Gaba et al., Anesthesiology, 69:387 (1988); M. L. Good, Int. Anesthesiology Clinics, 27(3):161 (1989); and U.S. Pat. No. 4,996,980, are known in the art. Further, lung simulators, such as those described in S. Lampotang, Crit. Care Med., 14(12):1055 (1986); M. L. Good, Anesthesiology, Abstract No. A982, 71:(3A) (1989); and U.S. Pat. No. 4,878,388 and other medical simulators, such as the simulator described in U.S. Pat. No. 4,907,973, which utilizes a video display of simulated internal conditions to model invasive or semi-invasive procedures, are known.
However, none of these disclosures addresses the simulation of neuromuscular stimulation, particularly the electrical stimulation of the ulnar nerve during anesthetized medical procedures or the electrical, auditory or visual external stimulation to produce evoked potentials. Because the results of neuromuscular stimulation can be difficult to interpret and because other factors, such as amount and kind of anesthetics, equipment malfunction or even the patient's temperature, can affect these results, there exists a need for a simulator capable of modeling neuromuscular stimulation. Further, there exists a need for a method to train medical personnel, particularly novice medical personnel, to use neuromuscular stimulation equipment of ever-increasing complexity and cost without putting the patient at risk of injury.
Throughout this application, various publications are referenced. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains.